Moon, Fredric

Moon, Fredric is an individual health care provider with primary practice located at 120 Mineola Blvd Suite 100, Mineola NY 11501-4073. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Moon, Fredric can be contacted via phone (516) 663-3010.

Contact Information

Primary practice address
120 Mineola Blvd Suite 100 Mineola NY 11501-4073
Phone: (516) 663-3010
Fax: (516) 663-3026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 216307 New York

Profile Details

NPI number 1104819242
LBN Legal business name Moon, Fredric
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Feb 9th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104819242 NPPES
New York MEDICAID 02382350

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